A Rare Case of Multicentric Reticulohistiocytosis

Main Article Content

Priscilla Ly
Paige Hoyer
Adrian Subrt
Brandon Goodwin
Brent Kelly


multicentric reticulohistiocytosis, histiocytes


Multicentric reticulohistiocytosis (MRH) is a rare, histiocytic disorder that primarily affects the skin and joints. This disease can have systemic involvement of various organ systems and has been associated with underlying malignancy. Middle-aged, Caucasian females are the most commonly affected demographic group in this disease. We present a case of a 56-year-old African American male with debilitating joint pain and a papulonodular rash on his face, chest, arms, and hands. Biopsy of skin lesions confirmed the diagnosis of multicentric reticulohistiocytosis. Histological findings revealed dermal infiltrate composed of glassy histiocytes and giant cells with eosinophilic cytoplasm. The patient was started on 15 mg of methotrexate weekly, 1 mg of folic acid daily, and 60 mg of prednisone daily with mild improvement of skin lesions at one month followup. He expired from other comorbidities before long term treatment could be achieved. The potential for disfiguring skin lesions and debilitating arthropathy emphasizes the importance of early recognition and treatment of MRH. Corticosteroids and methotrexate are recommended for patients with moderate to severe disease and have been shown to be successful in some cases. More studies are needed on patients with MRH to further elucidate the etiology and pathogenesis of this disease.


Rapini RP. Multicentric reticulohistiocytosis. Clinics in Dermatology. 1993;11(1):107-111. doi:10.1016/0738-081x(93)90105-l.

Tariq S, Hugenberg ST, Hirano-Ali SA, Tariq H. Multicentric reticulohistiocytosis (MRH): case report with review of literature between 1991 and 2014 with in depth analysis of various treatment regimens and outcomes. SpringerPlus. 2016;5:180. doi:10.1186/s40064-016-1874-5.

Lesher JL, Allen BS. Multicentric reticulohistiocytosis. J Am Acad Dermatol 1984;11:713-23.

Jha VK, Kumar R, Kunwar A, et al. Efficacy of Vinblastine and Prednisone in Multicentric Reticulohistiocytosis With Onset in Infancy. Pediatrics. 2016;137(6). doi:10.1542/peds.2015-2118.

Olson J, Mann JA, White K, Cartwright VW, Bauer J, Nolt D. Multicentric Reticulohistiocytosis: A Case Report of an Atypical Presentation in a 2-Year-Old. Pediatric Dermatology. 2015;32(3). doi:10.1111/pde.12531.

Hotta M, Minamimoto R, Suzuki D, Takahashi A. Multicentric Reticulohistiocytosis Mimicking Malignancy on 18F-FDG PET/CT. Clinical Nuclear Medicine. 2017;42(7):567-568. doi:10.1097/rlu.0000000000001661.

Barrow MV, Holubar K (1969) Multicentric reticulohistiocytosis. A review of 33 patients. Medicine 48(4):287–305

Islam AD, Naguwa SM, Cheema GS, Hunter JC, Gershwin ME. Multicentric Reticulohistiocytosis: a Rare Yet Challenging Disease. Clinical Reviews in Allergy & Immunology. 2013;45(2):281-289. doi:10.1007/s12016-013-8362-2.

Tajirian AL, Malik MK, Robinson-Bostom L, Lally EV. Multicentric reticulohistiocytosis. Clinics in Dermatology. 2006;24(6):486-492. doi:10.1016/j.clindermatol.2006.07.010.

Webb-Detiege T, Sasken H, Kaur P. Infiltration of Histiocytes and Multinucleated Giant Cells in the Myocardium of a Patient With Multicentric Reticulohistiocytosis. JCR: Journal of Clinical Rheumatology. 2009;15(1):25-26. doi:10.1097/rhu.0b013e31817d1197.

Macía-Villa CC, Zea-Mendoza A. Multicentric reticulohistiocytosis: case report with response to infliximab and review of treatment options. Clinical Rheumatology. 2014;35(2):527-534. doi:10.1007/s10067-014-2611-5.

Catterall MD. Multicentric reticulohistiocytosis a review of eight cases. Clinical and Experimental Dermatology. 1980;5(3):267-279. doi:10.1111/j.1365-2230.1980.tb01705.x.

Snow JL, Muller AS. Malignancy-associated multicentric reticulohistiocytosis: a clinical, histological and immunophenotypic study. Br J Dermatol 1995; 133: 71–76.

Malik MK, Regan L, Robinson-Bostom L, Pan TD, McDonald CJ (2005) Proliferating multicentric reticulohistiocytosis associated with papillary serous carcinoma of the endometrium. J Am Acad Dermatol 53(6):1075–9

Kishikawa T, Miyashita T, Fujiwara E, Shimomura O, Yasuhi I, Niino D et al (2007) Multicentric reticulohistiocytosis associated with ovarian cancer. Mod Rheumatol/Japan Rheum Assoc 17(5):422–5

Han L, Huang Q, Liao KH, Chen LJ, Kong WY, Fu WW et al (2012) Multicentric reticulohistiocytosis associated with liver carcinoma: report of a case. Case Rep Dermatol 4(2):163–9

Hinchman KF, Wu JJ, Soden CE Jr, Waldman J, Dyson SW (2008) Multicentric reticulohistiocytosis associated with Burkitt lymphoma and adenocarcinoma. Cutis; Cutan Med Pract 82(2):113–4

Tirumalae R, Rout P, Jayaseelan E, Shet A, Devi S, Kumar KR (2011) Paraneoplastic multicentric reticulohistiocytosis: a clinicopathologic challenge. Indian J Dermatol Venereol Leprology 77(3):318–20

Kenik JG, Fok F, Huerter CJ, et al. Multicentric reticulohistiocytosis in a patient with malignant melanoma: A response to cyclophosphamide and a unique cutaneous feature. Arthritis Rheum 1990;33:1047-51.

Honeyboume D, Kellett JK. A mesothelioma presenting with multicentric reticulohistiocytosis. Postgrad Med J 1985;61:57-9.

Trotta F, Castellino G, Lo MA (2004) Multicentric reticulohistiocytosis. Best Pract Res Clin Rheumatol 18(5):759–72

Baek IW, Yoo SH, Yang H, Park J, Kim KJ, Cho CS. A case of multicentric reticulohistiocytosis. Mod Rheumatol 27: 165-168, 2017.

Muñoz-Santos C, Sàbat M, Sáez A, Gratacós J, Luelmo J. Multicentric reticulohistiocytosis-mimicking dermatomyositis. Case report and review of the literature. Dermatology. 2007;214(3):268–271. doi: 10.1159/000099594.

Saba R, Kwatra SG, Upadhyay B, Mirrakhimov AE, Khan FN. Multicentric Reticulohistiocytosis Presenting with Papulonodular Skin Lesions and Arthritis Mutilans. Case Reports in Rheumatology. 2013;2013:201563. doi:10.1155/2013/201563.

Song SH, Kim HJ, Kang DH, Lim SY. A Case of Multicentric Reticulohistiocytosis Misdiagnosed as Rheumatoid Arthritis. Kosin Medical Journal. 2012;27(2):181. doi:10.7180/kmj.2012.27.2.181.

Fett N, Liu RH. Multicentric Reticulohistiocytosis with Dermatomyositis-Like Features: A More Common Disease Presentation than Previously Thought. Dermatology. 2011;222(2):102-108. doi:10.1159/000323254.

Webb-Detiege T, Sasken H, Kaur P. Infiltration of Histiocytes and Multinucleated Giant Cells in the Myocardium of a Patient With Multicentric Reticulohistiocytosis. JCR: Journal of Clinical Rheumatology. 2009;15(1):25-26. doi:10.1097/rhu.0b013e31817d1197.

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)

1 2 > >>